The American College of Radiology and the National Kidney Foundation have released statements regarding the exaggerated risk of acute kidney injury (AKI) in patients with reduced kidney function following CT scans using intravenous iodinated contrast media. This risk is thought to be overestimated mainly because of uncontrolled studies that are unable to separate AKI caused by contrast media administration (contrast-induced; CI-AKI) from AKI coincident to contrast media administration (contrast-associated; CA-AKI). The true risk of CI-AKI remains unclear, however prophylaxis with intravenous saline is indicated for patients with an AKI or estimated glomerular filtration rate < 30 mL/min/1.73 m2 who are not undertaking dialysis. Additionally, prophylaxis can be considered for high-risk individuals with an estimated glomerular filtration rate of 30–44 mL/min/1.73 m2. To conclude, prospective controlled data is necessary in adult and paediatric populations to determine the true risk of CI-AKI. Additional information can be accessed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh